Provider Demographics
NPI:1497580195
Name:PHILLIPS, SVEN JOSEPH
Entity type:Individual
Prefix:
First Name:SVEN
Middle Name:JOSEPH
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 N DELAWARE ST STE 606
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-3879
Mailing Address - Country:US
Mailing Address - Phone:508-395-7009
Mailing Address - Fax:
Practice Address - Street 1:1040 N DELAWARE ST STE 606
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-3879
Practice Address - Country:US
Practice Address - Phone:508-395-7009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program